Organization Active NPI

Excel Imaging Center Inc

  • Body Imaging Physician
  • Garden Grove, CA
National Provider Identifier
1962910513
Registry record updated Jan 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Body Imaging PhysicianTaxonomy code 2085B0100X
Legal business name
EXCEL IMAGING CENTER INC
Doing business as
Excel Imaging Center Inc
Practice address
13071 Brookhurst St Ste 100
Garden Grove, CA 92843-5514
Phone
(714) 583-8126
Fax
(714) 583-8148
NPI assigned
Jan 17, 2018
Last updated
Jan 17, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Khanh Duong, DPM
Title
Manager
Phone
(714) 583-8147

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Body Imaging Physician 2085B0100X NU Primary

Addresses

Primary practice location

13071 Brookhurst St Ste 100
Garden Grove, CA 92843-5514

Mailing address

13071 Brookhurst St Ste 100
Garden Grove, CA 92843-5514
Phone (714) 583-8126

Other names 1

  • Excel Imaging Center Inc Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180406001352 CA Part B Supplier - Clinic/Group Practice 3173886025 Receives reassigned benefits from 1 practitioner
Practice locations: Garden Grove, CA

National Provider Directory

National Provider Directory

Locations

13071 Brookhurst St
Ste 100
Garden Grove, CA 92843
Phone (714) 537-0547

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1516147200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1516147200000",
    "number": "1962910513",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13071 BROOKHURST ST STE 100",
            "city": "GARDEN GROVE",
            "state": "CA",
            "postal_code": "928435514",
            "telephone_number": "714-583-8126",
            "fax_number": "714-583-8148"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13071 BROOKHURST ST STE 100",
            "city": "GARDEN GROVE",
            "state": "CA",
            "postal_code": "928435514",
            "telephone_number": "714-583-8126",
            "fax_number": "714-583-8148"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EXCEL IMAGING CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-01-17",
        "last_updated": "2018-01-17",
        "status": "A",
        "authorized_official_last_name": "DUONG",
        "authorized_official_first_name": "KHANH",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "714-583-8147",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "2085B0100X",
            "taxonomy_group": "",
            "desc": "Radiology, Body Imaging",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Excel Imaging Center Inc",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Garden Grove, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.